Dental Tourism: Getting Drilled in Bangkok

It’s Colts 13, Houston 0 as the half winds down. My wife and I are watching Peyton Manning lead the Colts to yet another NFL victory on a big flat screen TV. Nothing strange about this, except its Wednesday afternoon and we are sitting in the lobby of the Dental Hospital in the heart of one of the poshest districts in Bangkok. Like many other cash-strapped seniors, we are dipping our toes into the wave of the future with our first adventure in medical/dental tourism.

This is not my first dental experience in Thailand. In the late 1990s, on a flight to Thailand for a business trip, I cracked a temporary bridge eating some nuts. It didn’t hurt and wasn’t much of a problem at first, but as I talked and chewed, the sharp edge of the broken bridge jabbed into my tongue. The easy solution – don’t eat or talk for two weeks -- was not an option, so the first thing I did upon landing in Chiang Mai was to ask my colleague who met me at the airport to recommend a dentist.

The dentist office did not look promising. It was dark and dinghy with equipment I hadn’t seen in years. The possibility of pain was the least of my worries, though. It was at the height of concern about the spread of AIDS throughout SE Asia, and I wasn’t at all sure that I wouldn’t get the disease from this hapless dental adventure. My heart started pounding and I broke out into a sweat. “Should I leave and risk looking like a wimp and insulting my colleague,” I asked myself, “or should I stay and risk pain and death?” The risk of embarrassment won out over the risk of pain and death, as it usually does for me.

As the dentist lowered my chair to get a better look, I gulped, or at least the closest thing to a gulp given the wad of cotton in my mouth. I caught a glimpse of my colleague in the waiting room smiling and waving to me as if I had nothing to fear. In just a few seconds I realized that he was right.

She was the most careful, cautious and gentle dentist to ever thrust hands into my mouth. I barely felt a thing as she filed down the sharp edge. It was all over in just a few minutes. She charged me five dollars for her work.

On a more recent trip to Thailand a few years ago, just as dental and medical tourism in the country were beginning to take off, another colleague explained to me how the Thais were able to develop such high level competence in dentistry and medical surgery. “When Thai women catch their husbands cheating on them,” he explained, “they cut off their penises while they are sleeping.” As a result, Thai doctors had a lot of practice reattaching the “offending member” and, in the process, developed world-class skills in microsurgery, skills that come in handy in gender reassignment, cardiovascular, and complex dental surgery. I don’t know if his explanation is accurate, but it sure got my attention.

This past fall my wife and I, facing looming dental bills, decided to give dental tourism in Thailand a try. Unlike the dental office years ago in Chiang Mai, the Dental Hospital in Bangkok is a gleaming white and chrome three-story building in Sukhumvit, the heart of the international district. Inside is an atrium, the waiting area, with a large man-made pond and a floor to ceiling wall of glass in the rear looking out on lush gardens and Koi ponds behind the building. The overall effect is serene, as serene as one can be while waiting for a dentist.

Most of the people in the lobby were Westerners, ergo the football game. For those not interested in American football, there is fast Wi-Fi access for those who bring their own laptops and a computer work station for those who don’t. This facility is clearly devoted to affluent Thais and tourists from the US, Europe, Middle East and elsewhere in Asia.

Katherine is the guinea pig for this experiment since her dentist in the States told her a few weeks earlier that she had two cracked fillings and needed to replace them with expensive crowns. After waiting for a few minutes in the atrium, she was ushered into an office where a dentist checked the X-rays, looked into her mouth and recommended, in excellent English, replacing the fillings instead. A second opinion, from another dentist across the atrium, was the same.

Over the next couple of weeks, Katherine returned three times to replace the two fillings in question and fill seven other cavities. The fillings were done so painlessly that Katherine – a serious dental chicken – only needed Novacaine twice. She claims that it was the easiest, most comfortable, and pain and anxiety free dental work she has ever had. The total bill came to about a third of what it would have cost in Los Angeles and a tenth of the cost of the work recommended by her dentist in LA. Six weeks later, the fillings are still intact and trouble free.

The overall experience exceeded even our most optimistic hopes. Everyone on the staff – dentists, receptionists, technicians and others -- spoke excellent English and was professional, attentive, and meticulous. The dentists were gentle and reassuring and seemed to be sensitive to the kinds of concerns that wary Westerners might have, like the concerns I had years ago in Chiang Mai. We appreciated the efficiency of the inclusive team-oriented approach, with all services from general dentistry to complicated implants, all available under one, gleaming roof.

To make sure that our experience was not the exception, we spoke to a Western couple we met in the waiting area. They told us that they live in Hong Kong but travel to Bangkok at least once a year for medical and dental procedures and exams and are very satisfied at the results, and especially the cost.

The overall experience was so positive that we almost look forward to doing it again next year. Hard to believe we are actually talking about going to the dentist….

Mahout Training in Northern Thailand

My wife, Katherine, likes large mammals – gorillas, bears, whales, hippos, even me. That is why I am sitting on a very large elephant, riding bareback, at the Thai Elephant Conservation Center (TECC; http://www.changthai.com/) about 20 miles outside of Lampang in northern Thailand. We are here for three days of mahout training, an introduction to the basics of elephant care and handling.

The TECC is one of several centers located throughout Thailand dedicated to protecting this revered national symbol. For centuries, elephants were used to log teak forests, transport goods through the mountains, and perform any task that required serious muscle. Since logging was banned in 1989 to protect Thailand’s forests, these magnificent beasts have been put out to pasture, literally and figuratively. Many have been exploited in tacky tourist shows; others by their desperate mahouts who bring them to the big city to cadge a few baht from tourists who feed them bananas and take photos. Even more tragic are the hundreds, maybe thousands, that have been poached – murdered – for the ivory in their tusks.

The elephant preserves, like TECC, help save Thailand’s elephants by providing a financial incentive to the local communities to protect rather than poach the animals. The centers also educate tourists and school children about the role of the elephant in Thai history and provide them with medical care and treatment. The main attraction at most of the preserves are the elephant shows which showcase traditional skills such as moving, hauling and lifting logs, and responding to the commands of their mahouts, as well as more gimmicky tricks like painting pictures and playing xylophones.

MY OWN PERSONAL ELEPHANT
The center also offers 1-3 day courses in mahout training, the reason we are here. We are signed up for the three day course, along with three others. Our group of five ranges in age from 30s to the mid 60s and represent three different countries.

Just a few minutes after our 8:30 am arrival at the Center, we are wearing our blue mahout suits (with pants big enough for both my elephant and me) and trying to memorize the basic commands, in Thai, from a one page cheat sheet. Before I have barely mastered what I consider to be the most important command, “how” for “stop,” we are each introduced to our very own elephants and mahouts.

Mine is huge (the elephant, not the mahout). Won, my mahout, barks a command, and Poomphwoum (or something like that) bends her front leg back towards me. Won motions for me to step on her leg and pull myself up by holding an ear in one hand and a roll of skin in the other. Somehow, with absolutely no skill and less grace, I manage to get on. Before I can even process the idea that I am actually sitting on an elephant 8-10 feet off the ground, Won starts running through the basic commands and I practice getting on and off.

It’s a bit scary at first sitting on top of this behemoth bareback with nothing to hold on to. I balance myself with the palms of my hands resting on the two lumps on the back of her head. It is my only means of support and seemingly all that keeps me from falling off.

Soon, too soon, we are riding our elephants in single file to the lake a hundred or so yards away. The elephants ease into the lake just as a tour bus pulls up. With the tourists’ cameras clicking away, the elephants dunk themselves -- and therefore us -- for the first of several times over the next two and half days. After the initial shock of being up to our shoulders in muddy, but thankfully, warm water and realizing that we won’t drown, we laugh and frolic as our elephants dip, rise, and spray us with their trunks. With instructions from our mahouts, we make our first clumsy attempt to wash our elephants.

Then it’s back to the open air amphitheater for the show. Instead of watching the show, we soon realize that we are still part of it. We ride into the amphitheater waving triumphantly to the amazed audience. After a few minutes of demonstrating how to get on and off, we are finally off duty for a few minutes as the real mahouts lead the elephants through their paces for the rest of the show.

Following the show, we check into our rustic bungalows at the adjoining Chiang Thai resort on a lush, green, jungle-covered hillside, change out of our wet mahout suits, and have lunch. After a brief rest, we return to our elephants and ride them deep into the jungle. It is an amazing way to experience the jungle – a quiet, swaying ride on the back of a huge animal, at “chirp” level, to use Katherine’s words, an animal that is as intrinsic to the setting as the trees and brush.

We ride for about two hours, get another dunking in a lake, then leave our elephants behind, tethered in place with a very long chain, and walk back on the trail for a ride to our bungalows. The image of “my” elephant as I look back, feeding in a field with the jungle as background, is unforgettable.

The Center’s staff cooks us an excellent Thai dinner featuring lots of fresh vegetables and tall bottles of Thai beer. The air is cool and there are few mosquitos. As we get ready for bed, Katherine pretty much sums up the day -- “There is nothing as thrilling as riding your own elephant through the jungle. Temples are great but this gets my heart pounding.” For the first time since we arrived in Asia three weeks ago, we don’t hear a thing as we fall asleep except for the occasional chirp of a bird or insect.

RIDING TALL
We return the next day to the jungle and walk up the trail to where Poonphoum waits for us. It’s a strange feeling walking through the jungle, spotting a large elephant ahead of you and heading directly towards it. My instincts say stop, but of course it’s OK. We carry treats – stalks of bamboo – and Poonphoum seems glad to see us, or at least to see Won.

Over the next day and a half as we ride further into the jungle, I begin to feel more steady and comfortable, aside from a sore butt and inner thighs, and am able to appreciate what an extraordinary experience this is. I even begin to feel a little control – just a little – as I shout “bai, bai” (go, go) and nudge her with my knee in the direction I want her to go.

Riding bareback, I can feel the powerful muscles undulate under me. It’s not a fast power, like an overpowered automobile, but a slowly-push-through-anything kind of power. And its live power, driven by muscle and sinew, just like me but orders of magnitude greater. And it’s a power that I know I could not control if she ever got it in her head to ignore me or Won.

As we say goodbye to our elephants and mahouts on the last day, Katherine is moved to tears. So am I. Every one of us has been deeply touched by the experience and by the beauty, intelligence, agility and almost human-like qualities of these extraordinary animals. It’s hard to think of a three ton beast as gentle and lovable, but that is exactly what we feel. We turn often for one last glimpse of our elephants and a final wave to the mahouts who looked after us and put up with our bumbling but earnest attempts to live in their world, if only for a few days.